Referral Specialist Job at MercyOne Central Iowa Clinics

MercyOne Central Iowa Clinics Des Moines, IA 50309

$15.30 - $19.67 an hour
Overview

MercyOne Central Iowa operates four not-for-profit Catholic medical centers in Des Moines West Des Moines Newton and Centerville and two specialty hospitals – MercyOne Children’s Hospital in Des Moines and MercyOne Rehabilitation Hospital in Clive (965 beds total) – along with more than 20 additional facilities that house more than 50 primary care pediatric internal medicine and specialty clinics. Founded by the Sisters of Mercy in 1893 MercyOne Central Iowa has the longest continually operating hospital in Des Moines and is also one of the largest employers in the state with more than 7000 employees and a medical staff of more than 1000 physicians and allied health associates. MercyOne Central Iowa is a member of MercyOne which was founded in 1998 through a collaboration between CommonSpirit Health and Trinity Health – two of the country’s foremost not-for-profit Catholic health organizations. MercyOne has more than 20000 colleagues in Iowa and surrounding states.

We offer the following benefits to support you and your family:
  • Health/Dental/Vision Insurance
  • Flexible spending accounts
  • Voluntary Protection: Group Accident, Critical Illness, and Identity Theft
  • Free Premium Membership to Care.com with preloaded credits for children and/or dependent adults
  • Employee Assistance Program (EAP) for you and your family
  • Paid Time Off (PTO)
  • Tuition Assistance for career growth and development
  • Matching 401(k) and 457(b) Retirement Programs
  • Wellness Program

Responsibilities

Are you patient centered and thrive on providing top notch customer service? Consider joining our team as a PRN Referral Specialist. The Referral Specialist works with patients requiring a referral, to ensure patient’s referral needs are fulfilled for specialty service office visits. Processes referrals, authorizations and pre-certifications for patients, to ensure timely reimbursement.

Day-to-day
:
  • Gather, verify, and process referrals, authorizations, and pre-certifications by working closely with physician(s), patients, and payers.
  • Communicate detailed information and answers patients' questions regarding their health care plan; provide answers to billing and insurance clarification questions.
  • Set up appointments, coordinate clinic visits, and any special arrangements such as transportation, interpreter services, specialty care, etc.
  • Coordinate flow of information between medical clinic and referral authorization department to secure a valid referral for clinic patient.
  • Enter referrals, documents communications and action into the system, as appropriate.
  • Notify physician(s) and patient when referral is denied, or if additional information is needed.
  • Develop and maintain database of referral physician offices preferred by each physician within the clinic.
  • Assist Practice Manager with complaint resolution and solutions related to patient referrals.
  • Perform other duties as assigned by the practice manager or physician.

Qualifications
  • High school diploma or equivalent required.
  • 2 years of progressively responsible related experience in a healthcare environment required.

Pay Range
$15.30 - $19.67 /hour



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